Sunday, August 30, 2009

A baby born with known health problems died at two days old after doctors waited more than 24 hours before examining him. A scan during pregnancy showed Tobias Taylor had a dilated loop in his bowel, a potentially serious condition that needed careful attention. But despite clear medical records detailing the problem, medical staff not only waited 32 hours before fully examining him, but also let his mother Marie, 36, go home soon after the birth.

When he was finally examined, he was immediately rushed to a specialist unit where he died soon after of septicaemia. Now Mrs Taylor, a police community support officer, and her husband Simon, 39, are considering legal action against the hospital, claiming Tobias was given inadequate medical attention. Mrs Taylor, who visits her son’s grave every day, also claims she was not urged to remain in hospital the night after she gave birth, a charge the hospital denies.

She said: ‘If the hospital had acted as they should have and looked at my son straight away, he would be alive. ‘His graveside is the only place I feel at peace. I sit there for hours sometimes.’

National guidelines say doctors should wait 24 hours to give newborns a routine examination because this is when any heart defects can be spotted. But in letters to the family, the chief executive of East Surrey Hospital in Redhill admitted there had been staff ‘confusion’ and medics ‘did seem to lose sight of Tobias’s particular individual needs’.

Gail Wannell conceded: ‘Tobias did not fall into the category of babies who required the routine 24- hour examination.’ She added: ‘It would have been prudent for Tobias to be examined to see if there were signs of his condition deteriorating.’

Mrs Taylor, who lives in Redhill with her husband and sons Aden, seven, and Nicholas, 12, had been trying for a third child for six years when Tobias was conceived. But she became concerned when a scan on April 17 revealed that her unborn child had an enlarged bowel loop in his intestines, which can be an indicator of cystic fibrosis, which her son Nicholas has. It can also mean the intestines are blocked and need surgery. This should have been investigated straight after birth, but when Tobias was born at 2am on May 17, a note on Mrs Taylor’s records said: ‘Baby check not due till baby is 24 hours at 2am on May 18.’

Mrs Taylor said: ‘I asked for my baby to be checked, no one would even look at him. They told me I had to wait 24 hours, it was policy. ‘They didn’t tell me not to discharge myself in the meantime. If they had, I would have stayed.’ Mrs Taylor said she went home at 5.30pm and returned the next morning at 8.55am – but Tobias was not examined until 10.25am.

Soon after he was rushed to paediatric intensive care at St George’s Hospital in Tooting, South London, but died the next day. Mr Taylor said: ‘One of the hardest things we had to do was register the birth – then register the death straight afterwards. It was awful.’

A hospital spokesman said: ‘The medical teams discussed with Tobias’s mother their preference for Tobias to remain in hospital for monitoring and observation but the family chose to take Tobias home.’

Whatever else he said Wednesday evening at the town hall hosted by Rep. Jim Moran, D-VA, former Democratic National Committee chairman and presidential candidate Howard Dean let something incredibly candid slip out about President Obama's health-care reform bill in Congress.

Asked by an audience member why the legislation does nothing to cap medical malpractice class-action lawsuits against doctors and medical institutions (aka "Tort reform"), Dean responded by saying: "The reason tort reform is not in the [health care] bill is because the people who wrote it did not want to take on the trial lawyers in addition to everybody else they were taking on. And that's the plain and simple truth,"

Dean is a former physician, so he knows about skyrocketing medical malpractice insurance rates, and the role of the trial lawyers in fueling the "defensive medicine" approach among medical personnel who order too many tests and other sometimes unneeded procedures "just to be sure" and to protect themselves against litigation.

Texas Gov. Rick Perry recently described in an Examiner oped the medical-malpractice caps enacted by the state legislature at his urging that reversed a serious decline in the number of physicians practicing in the Lone Star state and the resulting loss of access to quality medical care available to Texas residents. Mississippi Gov. Haley Barbor also shared some of his successes in this area in a recent Examiner oped.

Credit goes to the American Tort Reform Association's Darren McKinney for catching this momentary outbreak of political honesty by Dean. McKinney has conveniently posted an audio recording of Dean speaking here, so you can listen for yourself. Mckinney has also offered more comment here, helpfully even including a link to the Examiner's recent analysis of the degree to which trial-lawyer political contributions go to Democrats in Congress.

Those contributions are why Dean knows it would be a difficult task indeed for Obama to persuade congressional Democrats to do anything that might offend the trial-lawyers lobby. The Examiner's David Freddoso and Kevin Mooney did the reporting on this link here.

The article below from the Left-leaning NPR claims that opponents of Obamacare are drumming up unfounded fears. Leftist would be experts about that. With all their shrill warnings about global warming, they sure have had a lot of practice at manufacturing fear (or trying to). More of that good ol' "projection" that Leftists rely so heavily upon. They assume that other people are just as disdhonest as they are

Past efforts to overhaul the nation's health care system had different proponents, different opponents and different plans that were under consideration. But they have two things in common: They all ended in failure, and in every case, opponents used fear as a key weapon in their arsenal.

So Jonathan Oberlander, a political scientist at the University of North Carolina at Chapel Hill, says he's not at all surprised to see recent claims — all thoroughly debunked — that suggest, for example, that bills under consideration would encourage senior citizens to commit suicide when they become ill or infirm.

"It's really a case of deja vu," he says. "You hear in today's debate echoes of the past that extend all the way to the early part of the 20th century. And I think the reason that people use fear again and again is that it's effective. It's worked to stop health reform in the past. And so they're going to try and use it in the present."

Oberlander says opponents used scare tactics the very first time the idea of national health insurance was broached — around 1915 — by tying would-be reformers to the nation's then-greatest international threat. "They said that national health insurance was a plot by the German emperor to take over the United States," he says.

The next effort to remake the health system came during the late 1940s. This time the opposition, led by the American Medical Association, exploited the newest fears. "They said if we adopted national health insurance, the Red army would be marching through the streets of the U.S.; they said this was the first step toward communism," Oberlander says.

By the time the Clinton administration took on the health effort, the power of the American Medical Association was fading. But now a new opponent took its place — the health insurance industry. It ran ads using an ordinary looking couple, named Harry and Louise, to raise doubts among middle-class Americans about how the Clinton plan might hurt rather than help them.

Says Oberlander, "The opponents have changed over time; the tactic of relying on fear and scaring Americans has not."

Yesterday I went to a health care “forum” featuring Henry Waxman that was definitely not a townhall. The event was a sham on so many levels, and I will deal with that soon enough.... This event was a luncheon at the Luxe hotel in Brentwood. The event was kept secret, and tickets cost $50. Supporters of Mr. Waxman were given preferential treatment. This was a tightly controlled campaign rally, not a real townhall. However, my main criticism involved a thug that works for the Luxe Hotel.

Normally people just drive up, with no issues. This time, a pair of men stopped me as I pulled up. They asked what I was coming to the hotel for. I explained to them that I was there to see the Congressman, and gave them my name. They saw I was on the list, and let me through. I figured that was it.

I took my Republican Jewish Coalition tote bag, emptied the contents, and put them in my National Football League tote bag. This was before I exited my car. I simply wanted to avoid controversy. I entered the luncheon room, began to eat my salad, and was then accosted by a Vice President of the Hotel, Seth Horowitz. I have never met Seth Horowitz before. Yet he claimed to know me. He told me that he knew who I was, and that if I had any intention of making a disturbance, I should leave immediately.

I was stunned by this. I was using my fork correctly. I told him I had no idea what he was talking about, and he emphasized that he wanted to make sure I did not cause any problems. This was mind boggling to me. There is nothing in my background to suggest I would do anything improper.

He actually threatened me, and if I was anything other than a white male, I would probably have a pretty decent civil rights claim. He told me that he would refund my money if I wanted, and that if I was not satisfied, he could have the police escort me out. I asked him flat out why he was even approaching me. He would not say. In fact, he kept saying over and over that he did explain it to me, but all he did was repeatedly say that he wanted to avoid problems. (Only after insisting that I was there for peaceful purposes did he leave me alone.)

I never got an answer to a basic fundamental question. Why did he think I would be a problem? What behavior triggered his reaction? For those wondering why this matters, think about some basic things.

Everybody who registered for this event gave their name. This Seth Horowitz fellow, based on something, “knew about me.” What did he know? Were guests investigated? Did the Valet people see the political tote bag, which I carefully turned around before giving them my car? If somebody were to google my name, it would take them several pages to find something. A jazz musician who plays saxophone and lives in San Francisco gets most of the attention. I am fine with this. So to find something about me would take some serious time and effort.

More importantly, was this mere overzealousness by a hotel employee making sure his esteemed guest was happy? If so, why all the secrecy and evasiveness by Mr. Horowitz? He did not seem to be harassing most people, and was beyond rude. Another Republican in the room had somebody looking over his shoulder the entire time, checking out what the fellow was doing with his Blackberry.

For those who think I am being paranoid, explain to me how an unassuming guy minding his own business can be targeted without explanation. Mr. Horowitz was willing to have me “taken care of,” which could mean anything from being asked to leave to something more violent. He is a physically imposing guy, and got right in my face. This was assault. I cannot imagine that Mr. Horowitz acted alone. Either Mr. Horowitz acted on direct orders, or he is a liberal activist. Yet how would he know my views?

I am going to repeat over and over again that I have never at any time in my life engaged in any political behavior that could be considered dangerous or threatening to anyone. My conversations with Congressman Waxman were cordial. He is my opponent, not my enemy.

Seth Horowitz might be the second coming of Rahm Emanuel, at least from a tactical standpoint. As for why he did what he did, he will not say. I want answers. Why was I targeted? What did he mean when he said that he “knew about me?” What does that mean? Whatever he “found out,” through what means did he find out?

I have never given a political speech at the Luxe Hotel. None of my political speeches have ever been videotaped. I have never had an event occur at the Luxe Hotel that would be considered remotely controversial.

This was not a random targeting. This man had a beef with me, and is not offering an explanation. Seth Horowitz is a bully on a power trip. The only thing bullies respect is force. I will be contacting every organization I have friends with, and plead with them to boycott the Luxe Hotel. I want answers. This is America. Every citizen has the right to peacefully assemble.

Congress Waxman’s people may have had nothing to do with this, but that theory defies logic. The whole situation stinks to high heaven. Seth Horowitz must be held accountable for his behavior. Otherwise, when he targets you, I will not be there to speak up.

Update: Seth Horowitz of the Luxe Hotel just called me and was very belligerent. He insisted that Congressman Waxman did not give the order to target me. When I asked if Congressman Waxman’s people gave the order, he clammed up. He said he did it based on my behavior. I asked him “what behavior?” He would not answer. He is hiding behind his lawyers, after accusing me of trying to sue the hotel.

I called back and emphasized to the very pleasant woman in the Executive Suite offices that I had zero interest in suing the hotel. I simply want an apology and an explanation. I also called Waxman’s office to find out more. While I suspect he may have an overzealous staffer or two, I do not have any evidence at this time that Congressman Waxman was directly involved.

After decades of government-run care, some Indians are finally saying enough.

Montana Sen. Max Baucus, a leading architect of national health-care reform, visited the Flathead Indian Reservation near Pablo, Mont., in May, and he was confronted with a surprising critique. "I hope any [new health-care] plan does not forget the nation's first people," Dr. LeAnne Muzquiz told the senator. Another person in the audience, according to the newspaper the Missoulian, followed up by telling the senator that the legislation pending in Congress would in fact do just that.

Native Americans have received federally funded health care for decades. A series of treaties, court cases and acts passed by Congress requires that the government provide low-cost and, in many cases, free care to American Indians. The Indian Health Service (IHS) is charged with delivering that care.

The IHS attempts to provide health care to American Indians and Alaska Natives in one of two ways. It runs 48 hospitals and 230 clinics for which it hires doctors, nurses, and staff and decides what services will be provided. Or it contracts with tribes under the Indian Self-Determination and Education Assistance Act passed in 1975. In this case, the IHS provides funding for the tribe, which delivers health care to tribal members and makes its own decisions about what services to provide.

The IHS spends about $2,100 per Native American each year, which is considerably below the $6,000 spent per capita on health care across the U.S. But IHS spending per capita is about on par with Finland, Japan, Spain and other top 20 industrialized countries—countries that the Obama administration has said demonstrate that we can spend far less on health care and get better outcomes. In addition, IHS spending will go up by about $1 billion over the next year to reach a total of $4.5 billion by 2010. That includes a $454 million increase in its budget and another $500 million earmarked for the agency in the stimulus package.

Unfortunately, Indians are not getting healthier under the federal system. In 2007, rates of infant mortality among Native Americans across the country were 1.4 times higher than non-Hispanic whites and rates of heart disease were 1.2 times higher. HIV/AIDS rates were 30% higher, and rates of liver cancer and inflammatory bowel disease were two times higher. Diabetes-related death rates were four times higher. On average, life expectancy is four years shorter for Native Americans than the population as a whole.

Rural Indians fare even worse, as data from Sen. Baucus's home state show. According to IHS statistics, in Montana and Wyoming, Indians suffer diabetes at rates 20% higher, heart disease 12% higher, and lung cancer rates 67% higher than the average across all IHS regions in the country. A recent Harvard University study found that life expectancy on a reservation in neighboring South Dakota was 58 years. The national average is 77.

Personal stories from people within the system reveal the human side of these statistics. In 2005, Ta'Shon Rain Little Light, a 5-year-old member of the Crow tribe who loved to dress in traditional clothes, stopped eating and complained that her stomach hurt. When her mother took her to the IHS clinic in south central Montana, doctors dismissed her pain as depression. They didn't perform the tests that might have revealed the terminal cancer that was discovered several months later when Ta'Shon was flown to a children's hospital in Denver. "Maybe it would have been treatable" had the cancer been discovered sooner, her great-aunt Ada White told the Associated Press.

Such horror stories are common on reservations, where the common wisdom is "don't get sick after June"—the month when the federal dollars usually run out. Late last year, the Montana Quarterly interviewed Tommy Connell, a member of the Blackfeet tribe and a worker in the IHS hospital in Browning, Mont. He didn't pull any punches in his assessment of the IHS. "They're lying to us," he said of promises over the years of more funds and better care. "You can pass just about any bill you want, but to appropriate money to that bill, that's another thing."

Dismal statistics prompted Mr. Baucus to declare a "health state of emergency" on the Fort Peck Reservation in northeastern Montana and to order an investigation of the IHS's use of funds. In July 2008, the Government Accountability Office reported that the IHS simply lost $15.8 million worth of equipment such as trucks and Jaws of Life machines between 2004 and 2007. It also found that $700,000 worth of computers were ruined by bat dung.

Tribal contracting—the alternative to IHS-run hospitals and clinics—offers some hope for improvement by giving tribes more flexibility in administering their own hospitals and clinics. Kelly Eagleman, vice-chairman of the Chippewa Cree Band on Montana's Rocky Boy's Reservation, understands the effect of a top-down bureaucracy. Of his tribe, he says, "We tend to want to blame a system, but we don't look at ourselves. We all smoke. We lay on the couch. But when something happens to us, we're the first to point and say that the clinic should have fixed us."

The Chippewa Cree Band has opted to provide its own health care with funding from the IHS. Dr. Dee Althouse, a physician at the Rocky Boy's Reservation, is still frustrated by funding constraints. She told the Montana Quarterly that she often finds herself working to save lives and limbs, deferring routine health care until there is money available. Yet even with limited funds, ongoing research by the Native Nations Institute reported earlier this year that tribal management leads to better access and better quality care than relying on the IHS-run system.

The Chippewa Cree Band runs its own hospital and has hired a registered dietician who has gotten the local grocery store to implement a shelf-labeling system to improve consumer nutritional information. They've also built a Wellness Center with a gym, track, basketball court, and pool. These are small steps that won't immediately eliminate heart disease or diabetes. But they move in the direction of local control and better health.

At a time when Americans are debating whether to give the government in Washington more control over their health care, some of the nation's first inhabitants are moving in the opposite direction.

No comments:

Background

Postings from Brisbane, Australia by John Ray (M.A.; Ph.D.) -- former member of the Australia-Soviet Friendship Society, former anarcho-capitalist and former member of the British Conservative party.

This blog gives a lot of attention to events in Australia and Britain -- places where there already exist systems similar to the one most likely to befall the USA if the Democrats get their way -- "Free" medical care supposedly available to all through government hospitals but with a competing private sector as well. The Canadian system is considered too Soviet to provide a likely model for the USA

TERMINOLOGY: Many of my posts concern the very instructive state of socialized medicine in Australia. Like the USA, Germany and India, Australia has a system of State governments which have substantial independence from the central (Federal) government and it is they who are mainly responsible for "free" health services. It may therefore be useful to some for me to note the standard abbreviations for the States concerned: QLD (Queensland), NSW (New South Wales), WA (Western Australia), VIC (Victoria), TAS (Tasmania), SA (South Australia).

For greatest efficiency, lowest cost and maximum choice, ALL hospitals and health insurance schemes should be privately owned and run -- with government-paid vouchers for the very poor and minimal regulation. Both Australia and Sweden have large private sector health systems with government reimbursement for privately-provided services so can a purely private system with some level of government reimbursement or insurance for the poor be so hard to do?

Conservatives do NOT object to helping the poor. Government welfare legislation in aid of the poor was in fact first introduced by conservatives -- Bismarck and Disraeli in the 19th century. What conservatives want is for the help to be delivered in a sane manner. And anyone who thinks that government bureaucracies can run hospitals well is completely out of touch with reality.

One of the oldest "free" public hospital systems in the world is that in the Australian State where I live: Queensland. It dates from 1944 (Britain's NHS began in 1948). So its advanced state of decay reveals well where the slow cancer of bureaucracy ends up. It now has three "administrative" employees for every medical employee. All those clerks are really good at curing people, I guess! Frequent bulletins on the flailing but ineffectual attempts to "fix" the system will appear here -- as well as bulletins on the dreadful things it does to patients and the long waits they endure.

On all my blogs, I express my view of what is important primarily by the readings that I select for posting. I do however on occasions add personal comments in italicized form at the beginning of an article.

I am rather pleased to report that I am a lifelong conservative. Out of intellectual curiosity, I did in my youth join organizations from right across the political spectrum so I am certainly not closed-minded and am very familiar with the full spectrum of political thinking. Nonetheless, I did not have to undergo the lurch from Left to Right that so many people undergo. At age 13 I used my pocket-money to subscribe to the "Reader's Digest" -- the main conservative organ available in small town Australia of the 1950s. I have learnt much since but am pleased and amused to note that history has since confirmed most of what I thought at that early age.

I imagine that the the RD is still sending mailouts to my 1950s address!

NOTE: The archives provided by blogspot below are rather inconvenient. They break each month up into small bits. If you want to scan whole months at a time, the backup archives will suit better. See here or here